Evidence-based information without the subscription: How much is free on the Internet?

Dr. John King, Milton Family Practice, searches for patient education materials

Public access to medical research publications is now a reality thanks to National Institute of Health (NIH) policies and recent legislation. NIH’s Public Access Policy requires that publications resulting from NIH-funded research are made publicly available on NLM’s open access repository PubMed Central (PMC) within 12 months of publication http://www.ncbi.nlm.nih.gov/pmc/. Health care professionals and community members seeking research-level information can often find credible evidence and resources using Google, Google Scholar or PubMed because these search engines index or search for information in PMC articles. Open access publishers such as PLoS (Public Library of Science) and BioMed Central also deposit full text articles on PMC without any waiting period. The National Library of Medicine provides a set of medical textbooks, clinical guidelines, and drug information free on the Internet. But is this free information sufficient to answer the many questions that arise in a clinical practice? So far, there is reason to think it isn’t.

Some of the best organized and most useful information is not free – far from it. Many journal articles or medical textbooks are not available online unless a hefty fee is paid to the publisher, often $50 or more for an individual article. Expert summaries like UpToDate and evidence-based reviews like DynaMed, that many physicians find convenient for point-of care, are developed by commercial publishers and require an annual subscription for individuals or institutions. Many individual practices and community hospitals are reluctant to pay the thousands of dollars required annually to subscribe to the electronic journal titles and clinical resources that providers might need.

While UVM/FAHC faculty, staff, and students have full electronic access to thousands of medical and health science electronic journal articles, clinical databases, textbooks and research engines, clinicians and researchers with no affiliation do not have this advantage. Community clinicians and the public are welcome to come to Dana Library to use subscription-based resources, but visiting is not a practical option for busy clinicians, even those in Chittenden or nearby counties.

Dana Library services support community hospitals and health care providers

How can unaffiliated Vermont clinicians obtain the evidence-based clinical information they need? As a Resource Library of the National Network of Libraries of Medicine and as part of UVM’s community service mission, Dana Library offers a set of services to health care providers, agencies and institutions that are unaffiliated with UVM or Fletcher Allen.  Journal article delivery service and literature search services are available at a reasonable cost (less than direct from the publisher). More information is found at http://library.uvm.edu/dana/services/unaffiliated.php. A web guide to resources with no license or subscription is also available: “Free Medical Resources to Support Clinical Care.”  http://danaguides.uvm.edu/freeresources. Some individual clinicians, practices and community hospitals in Vermont are already finding these services useful.

Marianne Burke.Mar29'07
Dana Director, Marianne Burke

What else can be done to integrate the medical and health content into clinical, community and public health services on a statewide basis? In some states, collaborations among AHECs, state library agencies, hospital administrators and librarians have developed mechanisms for statewide licensing of knowledge-based medical and health information for medical, professional and lay communities. Could it happen in Vermont? Dana Library and representatives of these organizations are exploring this sort of collaboration and feasibility. If the need can be established and institutional support gained, it may be possible.

Marianne Burke, MLS, AHIP
Director, Dana Medical Library

Dana Librarian Wins State Nursing Award

In November at the Annual Vermont State Nurses Association (VSNA) Conference Dana Librarian Angie Chapple-Sokol was awarded the VSNA Non-Nurse Distinguished Service Award for her stellar work with nurses across Vermont.

Nursing Librarian Angie Chapple-Sokol

Angie Chapple-Sokol has been working diligently for nurses at FAHC and throughout the state since fall 2005 when she became the Dana Nursing Liaison. Angie is an active participant on the Evidence Based Practice team of nurses at FAHC and has developed a library and research instruction program that is incorporated into every Central Nursing Orientation new nurses at FAHC must attend. These classes always get excellent evaluations and are cited as one of the high points of the entire orientation. Angie also offers educational opportunities for other nurses around Vermont.

Dana Participation at Breast Cancer Conference Goes from Pink to Green

Once again, the Dana Medical Library participated in the Exhibits Fair at the 2009 Breast Cancer Conference, sponsored by the Vermont Cancer Center. The goal of  Dana’s exhibit was to continue to spread the news about library resources and services for affiliated health care providers, students, and educators as well as for unaffiliated  users, including survivors, caregivers, and  community members. The Library has exhibited at this annual event since the first conference was held back in 1997. However, this year, the Library’s exhibit took on a more environmentally-friendly approach. An electronic Breast Cancer library guide was created to serve as a virtual information portal for the Conference. This “green” library guide provides links to Dana’s robust Consumer Health Collection (CHC) of breast cancer books and to breast cancer Internet sites. A simple, yet attractive, paper bookmark featuring the library guide website was designed and distributed to replace the many paper “pink” bibliographies and patient handouts from past conferences.

In addition, a display of some of the new CHC breast cancer books on Dana’s exhibit table caught the attention of many of the almost 700 attendees at this year’s conference.

New Online Resources

cotton blue2Indiana Pathology Images: Mycology

Dana Library is pleased to announce the acquisition of a new resource, the Indiana Pathology Images™ Mycology database.

From their description:

“The Indiana Pathology Images™ Mycology database, containing more than 600 photomicrographs, was developed for the purpose of providing a visual atlas that would serve as a resource for students and practitioners alike. The criteria used in selecting the “Grouping” of fungi in this atlas was an arbitrary determination by the authors who recognize that there are some fungi that may be included in more than one group. The authors included not only the “textbook” perfect images but also examples of the not-so-perfect morphologic appearances often observed in clinical specimens. It is beyond the scope of this database atlas to be all-inclusive and the authors recommend that comprehensive texts continue to be used as references when identifying fungal pathogens.

The authors have gone to great lengths to assure the standardization of image sizes. For comparative purposes, magnification is provided for all microscopic images. Since this CD has been designed for use as a “visual” review and image resource, text has been limited. For detailed discussion and descriptions, the authors recommend use of other clinical mycology resources (e.g., textbooks, websites).”

Image above: Epidermophyton floccosum – Microscopic Morphology, 100x Lactophenol cotton blue from Indiana Pathology Images Mycology.


Current Protocols

Current Protocols provides up-to-date methods for scientific research in 14 titles spanning the life sciences. Scientists contribute methods in areas of research identified by the Current Protocols editorial board members. The board members—along with a full-time, in-house editorial staff of M.S. and Ph.D. scientists—then review, fine-tune, and edit the content for clarity, consistency of style, and presentation. Already-published procedures are reviewed periodically and revised “as needed” to keep all the protocols up-to-date. Most titles are updated quarterly—both in print and online.

For years the Dana Medical Library has subscribed to many of these titles in print. The Library is pleased to announce that 6 Current Protocols titles are now available electronically:

Dana also receives Current Protocols in Immunology and Current Protocols in Molecular Biology in print.

For more information on Current Protocols, including a handy tutorial, see Current Protocols on the Library’s web site.

Tubes photograph by striatic used in accordance with the Creative Commons license.

EndNote How-To

paperOne of Dana’s most-used services is assistance with EndNote. And now, thanks to librarian Angie Chapple-Sokol, a new Online Resource Guide [http://danaguides.uvm.edu/Endnote] has been created to assist patrons in their use of EndNote, the bibliographic management software that helps organize your references and produce bibliographies for the preparation of papers and grants. This guide covers EndNote basics, choosing EndNote or EndNote Web, creating a library, managing the library and using the citations in your writing.

Editing a paper photograph by Nic’s events used in accordance with the Creative Commons license.

Spotlight on: Current Protocols in Bioinformatics

Where do YOU go for genome information these days? What’s the difference between GenBank, Online Mendelian Inheritance in Man, and the UCSC Genome Browser? Could one of these databases help you in your research? What other interdisciplinary, biochemical databases are available? And how can they be used effectively?

Current Protocols in Bioinformatics is a good place to begin learning about these resources. It contains information for the beginning bioinformaticist as well as the veteran researcher. Chapter 1, Using Biological Databases, provides individual units detailing the contents and use of the three resources mentioned above and thirteen other biological databases dealing with genes and proteins. Chapter 14, Cheminformatics, contains an introduction to chemical informatics as well as eight units about individual databases such as Pharmabase, Chembank, and ChEBI.

The individual chapters in each of these units contain general how-to information as well as examples to illustrate the use of the databases. In addition to the introductory sections there are another dozen chapters about topics such as: recognizing functional domains, modeling structures based on sequence, analyzing molecular interactions, and more.

In addition to Current Protocols in Bioinformatics, Dana also has electronic versions of Current Protocols in Cell Biology, Human Genetics, Microbiology, Molecular Biology, and Protein Science.

For more information about searching Current Protocols see this tutorial.

H1N1 Flu: 1918-19 & 2009


Ninety years ago, the 1918-19 Flu Pandemic was called the “greatest medical holocaust in history.” Best estimates put the worldwide death toll anywhere from 50 to 100 million people.  The H1N1 virus, an unusually virulent strain of influenza A, was identified as the deadly culprit behind that pandemic. Now, fast-forward to 2009, and the H1N1 virus has re-emerged around the world with a vengeance.

A new exhibit at the Dana Medical Library, H1N1 Flu: 1918-19 & 2009, traces the epidemiological and historical aspects of this virus in two different centuries. The images and texts in the exhibit hope to shed some light on the virus’ impact on a world at war, on student life at UVM, and even on literary works on the shelves at the Bailey/Howe Library. Current 2009 influenza statistics from the Vermont Department of Health will be monitored and posted weekly for this dynamic display.

Dans l’air du temps (d’actualité) photo by =xAv= used in accordance with the Creative Commons License.

Jing and Learning 2.0 Headline at Regional Library Conference


For thirteen years the Dartmouth Biomedical Libraries have offered the October Conference to New England librarians. The idea behind the conference is to have a day-long series of short presentations on one topic that are focused on the more practical aspects of librarianship. As library staff across New England knows, this conference is well-attended, timely and always informative.

This year two employees of the Dana Medical Library presented at this popular conference whose theme this year was, “Staff Development on a Shoestring.”

Colin McClung at the October Conference

Colin McClung, Circulation Assistant at Dana, presented “Using Jing to Add Swing to Your Tutorials.” Colin discussed Jing, a free, downloadable program that allows screen capturing, annotation and sharing, and how he’s used it to make high-quality “How To” guides for his student worker orientations. He also uses Jing to create many of the visual tutorials now available on the Dana Library web site. [See this recent post for more information.] As one attendee tweeted during the conference:  “Anxious 2 try Jing; looks easy peasy!”

Donna O'Malley

Donna O’Malley, Library Associate Professor and head of the education program at Dana, presented “Adapting a Learning 2.0 Program” about Dana’s adaptation of the Public Library of Charlotte & Mecklenburg County’s experiential learning program for Dana’s library staff. She noted that Learning 2.0 enabled staff at Dana to use Web 2.0 technologies and become internet contributors as well as consumers.

See the Darmouth October Conference site for more information, and links to these and other presentations.